半蹲式跳伞胫腓骨及踝关节骨折损伤分型及骨折区段分析
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1.北京航空航天大学 生物力学与力生物学教育部重点实验室 北京市生物医学工程高精尖创新中心 生物与医学工程学院,北京100083;2.北京航空航天大学 生物力学与力生物学教育部重点实验室,北京市生物医学工程高精尖创新中心,生物与医学工程学院,北京100083;3.空军特色医学中心,北京 100142;4.北京航空航天大学 生物力学与力生物学教育部重点实验室,北京市生物医学工程高精尖创新中心,生物与医学工程学院,北京100083 北京航空航天大学 医学科学与工程学院,北京 100083

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Fracture classification and injury segment analysis of tibiofibula and ankle in half-squat parachuting landing
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    摘要:

    摘要: 目的 对跳伞着陆中胫腓骨和踝关节骨折病例进行分型及损伤区段测量分析,探究伞伤骨折的主要类型和易发区段。方法 收集并筛选得到56例跳伞着陆骨折损伤病例,基于数字化X光片图像对胫腓骨和踝关节骨折分别使用AO-OTA标准和Lauge-Hansen标准进行分型,将与踝关节胫骨和距骨关节面的距离相等的平面定义为零平面,标定胫腓骨损伤最高和最低点以确定骨折区段并进行统计分析。 结果 胫腓骨和踝关节伞伤骨折中,胫腓骨一并骨折占80.4%。胫腓骨骨折以42-D/5.2(45.8%)、42-D/5.1(16.7%)为主要分型;踝关节骨折以旋前外旋型(59.4%),旋后外旋型(37.5%)为主要分型。在胫腓骨及踝关节伞伤骨折时,胫骨骨干在零平面向上57-143mm、零平面以下6mm至以上24mm的区段、腓骨在零平面以上4mm到45mm、74mm到83mm的区段内均有超过50%概率存在骨折损伤。 结论 在跳伞下肢损伤防护中,胫腓骨骨干均骨折的情况应被重点防护,旋前外旋和旋后外旋这两类踝关节骨折的扭转机制应该予以重点防护。胫骨骨干在零平面向上57-143mm的、零平面以下6mm至零平面以上24mm的区段、腓骨在零平面以上4mm到45mm、74mm到83mm的区段应予以重点防护。

    Abstract:

    Abstract: Objective To undergo classification and segment measurement of for patient cases with fracture injuries at tibia, fibula or ankle, and investigate fracture injury rules in half-squat parachuting landing. Methods 56 patient cases with fracture in parachuting landing were collected, and the tibiofibula and ankle fractures were classified according to AO-OTA or Lauge-Hansen classification standards respectively based on digital X-ray image. The plane between talus and tibia joint planes in ankle joint was defined as the reference plane. The location and length of fracture segment on tibia and fibula were measured. Results Patients with fracture of both tibia and fibula were 80.4% of all patients. The major classification for fracture of tibiofibula was 42-D/5.2 (45.8%) and 42-D/5.1 (16.7%). The major classification for fracture of ankle was pronation-external rotation (PER, 59.4%) and supination-external rotation (SER, 37.5%). The fracture segment of tibia was mainly from 57 to 143mm above the reference plane and from 6mm below the reference plane to 24mm above the reference plane, while the fracture segment of fibula from 4mm to 45mm and from 74mm to 83mm above the reference plane. Conclusions In the protection of lower limb in parachuting landing, the fracture occurred both on tibia and fibula should be highly noticed. The ankle motion of pronation-external rotation and supination-external rotation should be especially restricted in parachuting ankle protection. Emphasized protection should be performed on tibia in the segment from 57 to 143mm above the reference plane and from 6mm below the reference plane to 24mm above the reference plane and on fibula from 4mm to 45mm and from 74mm to 83mm above the reference plane.

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  • 收稿日期:2021-03-25
  • 最后修改日期:2021-06-24
  • 录用日期:2021-06-30
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